Surgical treatment of chest deformities

Хирургическое лечение деформаций грудной клетки
Azat Satzhanov 1, Marat Rabandiyarov 1, Bolat Nagimanov 2
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1 Zhambyl Regional Children’s Hospital
2 Corporate fund “University Medical Center” National Research Center for Maternal and Child Health, Astana, Kazakhstan
J CLIN MED KAZ, Volume 3, Issue 45 special issue, pp. 22-24. https://doi.org/10.23950/1812-2892-JCMK-00509
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ABSTRACT

The purpose of the study: evaluation of clinical outcomes after thoracoplastic operations, including D. Nass in children with various forms of chest deformities.
Methods: 28 thoracoplastic surgeries were performed on the basis of the Zhambyl Regional Children's Hospital from 2015, and 3 of them in cooperation with specialists from the UMC "NSMC". By sexual ratio, boys prevailed (1:3,6). According to the types of deformities 55.6% of the pectus excavatum, 21.4% of the Poland syndrome, 14% of the pectus carinatum. All the children underwent radiological studies: radiography, CT with the defnitions of the Gyzick and Haller indexes.
Results: Indication for an operative intervention with a funnel-shaped cosmetic defect of the chest, the Haller index is more than 3.25; the Gizyck index is less than 0.65. The average duration of operations was 56.39 ± 1.40 min, the time spent in the intensive care unit was 1.14 ± 0.12 days, and the time spent in the pediatric orthopedics department was 12.35 ± 1.15 days. Based on the results of IG in the pre-operative period averaged 0.59, after the operation the mean IG increased to 1.00, which shows a correction of the chest. Differences of IG in the preoperative and postoperative periods demonstrate an increase in the IG index by an average of 85.0% of the initial.
Conclusions: According to our observations, the results of D. Nass's operation under endovision, in the postoperative period, show good and satisfactory results to 85% of cases, with a low risk of complications. When fxing the plate, it is recommended to strictly observe the operating technique: epipleural implant insertion, blockage of the ends with short transverse plates, which contributes to the stability of the metal structure.

CITATION

Satzhanov A, Rabandiyarov M, Nagimanov B. Surgical treatment of chest deformities. Journal of Clinical Medicine of Kazakhstan. 2017;3(45 special issue):22-4. https://doi.org/10.23950/1812-2892-JCMK-00509

REFERENCES

  • Jaroszewski D, Notrica D, McMahon L, Steidley DE, Deschamps C. Current management of pectus excavatum: a review and update of therapy and treatment recommendations. J Am Board Fam Med. 2010;23(2):230–239. doi:10.3122/jabfm.2010.02.090234
  • Nuss D, Obermeyer RJ, Kelly RE Jr, . Pectus excavatum from a pediatric surgeon's perspective. Ann Cardiothorac Surg. 2016;5:493–500. doi:10.21037/acs.2016.06.04
  • Kelly RE Jr, Mellins RB, Shamberger RC, et al. Multicenter study of pectus excavatum, final report: complications, static/exercise pulmonary function, and anatomic outcomes. J Am Coll Surg. 2013;217(6):1080–1089. doi:10.1016/j.jamcollsurg.2013.06.019
  • Jo WM, Choi YH, Sohn YS, Kim HJ, Hwang JJ, Cho SJ. Surgical treatment for pectus excavatum. J Korean Med Sci. 2003;18(3):360–364. doi:10.3346/jkms.2003.18.3.360
  • Sacco Casamassima MG, Goldstein SD, Salazar JH, McIltrot KH, Abdullah F, Colombani PM. Perioperative strategies and technical modifications to the Nuss repair for pectus excavatum in pediatric patients: a large volume, single institution experience. J Pediatr Surg. 2014;49 (4): 575–582. doi:10.1016/j.jpedsurg.2013.11.058